NPIMap

Organization Active NPI

Veteran's Administration

  • Federally Qualified Health Center (FQHC)
  • Decatur, IL
National Provider Identifier
1043323793
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VETERAN'S ADMINISTRATION
Practice address
3035 E Mound Rd
Decatur, IL 62526-9650
Phone
(217) 875-2670
Fax
(217) 875-2689
NPI assigned
Aug 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Geraldine Thornhill Wirth, A.P.R.N.
Title
Nurse Practitioner
Phone
(217) 875-2670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X IL Primary

Addresses

Primary practice location

3035 E Mound Rd
Decatur, IL 62526-9650

Mailing address

632 E Bodman St
Bement, IL 61813-1206
Phone (217) 620-8891

National Provider Directory

National Provider Directory
Tax ID family
Danville Vamc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3035 E Mound Rd
Decatur, IL 62526
Phone (217) 554-3000

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043323793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 E BODMAN ST",
            "city": "BEMENT",
            "state": "IL",
            "postal_code": "618131206",
            "telephone_number": "217-620-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 E MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269650",
            "telephone_number": "217-875-2670",
            "fax_number": "217-875-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VETERAN'S ADMINISTRATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIRTH",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_middle_name": "THORNHILL",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "217-875-2670",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "A.P.R.N."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.